Married. emmental officials and advocated radical reforms. He next joined in the publication of a periodical called Medizinische Re¬ Anthony L. "Rettaliata, M.D., to Miss Agnes M. Ryan, both form, devoted to politico-medical reform measures and in which •of Baltimore, August 27. among other changes there was urged the establishment of a W. B. Kirkpatkick, M.D., to Miss Susie A. Brinley, botli of ministerial bureau for public hygiene. His active participation Path Valley, Pa., August 15. in the liberal movement connected with the revolutionary efforts J. Talley Spence, M.D., Alma, I. T., to Miss Mary R. Brand, of 1848 led to his dismissal from public positions in Berlin, and •of Memphis, Tenn., August 30. he accepted the offer of the chair of pathological anatomy in William F. Berner, M.D., Merrill, Iowa, to Miss Hannah Würzburg, the university of which was the first to establish Boubeck of Chicago, August 27. a full chair in this branch. Here he continued his investiga¬ Robert M. Andrews, M.D., to Miss Clara Louise Church, tions, interested himself in the of a scientific 26. deeply development 'both of Bergen, . Y., August in the and in the matter of accurate Miss atmosphere university Adams . Howard, M.D., Cleveland, Ohio, to Madge statistics of local diseases. He assumed co-editor¬ Armor of 4. municipal Wooster, Ohio, September of Canstatt's Jahresbericht which since 1867 has been Louis L. . to Miss Catherine ship pub¬ Gilman, M.D., Rochester, H., Virchow and Hirsch. In "Cunningham, of New York, August 11. lished by 1856 he was recalled to Berlin as Professor of General Walter E. Foster, M.D., Richmond 111., to Miss Clara Pathological Anatomy, Pathology Emma Marckhoff of 111., 21. and Therapy and Director of the Pathological Institute, and Elgin, August here Guy L. Noyes, M.D., Ann Arbor, Mich., to Miss Lucia he remained until the end of his life. Only last year a Weigand of Traverse City, Mich., August 27. magnificent new building was erected for his laboratory, and John J. Flynn, M.D., Worcester, Mass., to Miss M. Agnes in order to house adequately the great museum that he had Sweeney of North Abington, Mass., August 27. created during his long tenure of office. Porter Bruce Brockway, M.D., Toledo, Ohio, to Miss Eva While in Würzburg some of his more important original of Lake 26. Marjorie Plews Linden, Mich., August investigations were published, notably those on the chemistry and morphology of the blood and on thrombosis and embolism. Deaths and Obituaries. The work on thrombosis and embolism is to a large extent experimental, and it constitutes the real starting point of our definite knowledge of these fundamental processes. In 1858 THE DEATH OF PROFESSOR VIRCHOW. appeared his "Cellular Pathology," based upon lectures given to Rudolf Virchow is dead. With his death on September 5, physicians especially, and long recognized as an immortal classic one of near the end of his eighty-first year, there passed away that virtually created a new era in medicine. The famous that the most influential investigators, leaders, and teachers phrase "omnis cellula e cellula" "sounded the death-knell of medicine has known. The epochal significance of his great the old humoral pathology and the birth of the new cellular and the of much of his work generalization basal importance pathology," which led to systematic study of the changes pro¬ will make the name of Virchow forever prominent as are only a duced by disease in the constituent elements of the organism. few in the history of the development of medicine. Endowed Only in this way could it ever have been possible for the with a remarkable intellectual endurance he was to permitted student to penetrate close to the real secrets of natural proc¬ continue his many-sided activity until well past the venerable esses, pathologic as well as physiologic, and to arrive at general age of four score. Some months, ago he suffered an accidental laws that would permit the formulation of scientific hypotheses fracture of the hip; from the effects of this—at that age—so in medicine. By means of the principle established by Virchow -ominous an injury, be apparently made a satisfactory recovery, "all medicine came nearer natural processes by at least three but only to meet with a second and more serious accident that hundred times" (Virchow), and pathology became that branch eventually led to his death. of biology which studies the disorders of cells and cell com¬ Only the merest outline can be given at this time of the plexes. It is as the founder of cellular pathology, which and eventful career of this versatile busy genius—path¬ Virchow himself was the first to recognize as the natural de¬ ologist, anthropologist, archeologist, hygienist and reformer. velopment and application of the work of his predecessors, Oct. in in he Born 13, 1821, Schievelbein Pomerania, especially Morgagni and Biehat, and of discoveries and gener¬ studied medicine in from 183!) to where he Berlin 1843, alization by investigators in other fields, that Virchow's name under influence of Johannes in the came the lasting Müller; will ever remain an eminent landmark in the history of medi¬ fall of 1844 he became prosector under Robert Froriep at the cine. Medical men the world throughout are familiar with this Charité in Berlin, and in two years more the latter's successor. aspect of his achievements. It is part and parcel of their medi¬ The direct outcome of this early work as prosector was a funda¬ cal education and thought, and though volumes could be written mental in the of change technic postmortem examination—pro¬ concerning the various phases of cellular pathology as it now ducing eventually a technic that became the world's standard— presents itself in the light of developments that have taken and introducing a system of reliable autopsy records. Those who place since Virchow retired from active investigation—it is were privileged to witness these early autopsies were electrified now nearly half a century since he fought and won the battle the secrets dead bodies were made to tell. In 1847 he and by for the principle of cell pathology—this is not the time nor Benno Reinhardt founded the Archiv für Pathologische An¬ the place for any extended discussion. atomie und Physiologie und für klinische Medicin, commonly From the beginning of the publication of his Archiv in 1847 known as Virchotv's Archiv, and since Reinhardts death in Virchow strongly opposed rationalism and empiricism in 1852 conducted Virchow alone. Virchow's Archiv is now by medicine, declaring that the time had come for the application its 169th volume and forms one of the most running important of the inductive method to medical investigation. What was in scientific medical literature because of the serials many needed was close observation of individual cases clinical articles the results of valuable in¬ by pioneer embodying original and anatomical methods. In the very first volume, in the vestigations, especially in the field of pathological anatomy and famous article in which he laid down the lines along which that have been in it. The influence this histology, published medicine was to advance—and along which it did advance—he Archiv has had on the of scientific in medicine growth study says: "The filling of the clinical positions in a hospital has can be of the earlier have not overestimated. Many volumes now become a matter of supreme importance because the clin¬ been and again in order to fill the demands reprinted again ician must be not only a scientific practitioner, but also an ob¬ for complete sets in public and private libraries. The earlier server and investigator"—a remark of special significance when numbers are valuable, too, because contain many especially they to American conditions and to articles by Virchow himself in which he develops his views in applied to-day the discussions now carried the real regard to the state of scientific medicine in those days. on concerning university medical school. of the and In 1848 Virchow made a medico-sociologie study of a Virchow's organization teaching investigation of devastating epidemic of typhus fever in Upper Silesia, and pathologic anatomy was nothing less than masterly. It re¬ in his report he fearlessly exposed the shortcomings of gov- sulted in the pathologic institutes, or laboratories, which we

Downloaded From: http://jama.jamanetwork.com/ by a Carleton University User on 06/19/2015 now know are indispensable for teaching and research. His Orth, Cornil, Reisz, Axel Key, Grawitz, Cohnheim, who died all official to the on need report government the and scope of such too soon, beside many, many more, have reached great promin¬ establishments with various subdepartments, like chemical ence as teachers and investigators who carried the cellular written in remains laboratory, museum, etc., 1846, still worthy principle of the great master to new centers, where its stimu¬ of those interested. we was study by Thus see clearly that he lating influence soon was felt. In 1863-67 he published his and to the on applying general scientific principles methods study great work tumors. Though never finished it remains to and investigation in medicine, and so successful were the this day perhaps the most valuable work for consultation in efforts to put an end to the day of "systems" and dyscrasias regard to the subject. His literary activity assumed large a few later he felt to write: that years encouraged "The proportions and he entered many other fields of knowledge scientific method of medical research is established. It than firmly the purely pathologic. He became an authority in an¬ is not merit to have discovered it. Without me it would and my thropology, archeology, and achieved almost as great a

have been found and the new trail would have been followed. reputation as writer and among the workers in But I trust the battle investigator against the existing mixture of arbitrary these sciences as he did in pathology in the minds of those rationalism and gross empiricisms, fought by the Archiv, who think of him as a pathologist only, and remain in ignor¬ in which I have aided by the introduction of genetic investi¬ ance of the versatility, one is tempted to say universality, of gation, may have contributed much in procuring new aims for his genius. pathology." There is one aspect of Virchow's work that merits special Virchow became famous at a remarkably early age, and his mention because of the example he here placed before scientific fame soon passed beyond the confines of Germany. Before long men and medical men in particular. We refer to his con¬ students from other lands were uttracted to him, and thus the tinuous activity, during his long life, in political and medico- waves of his influence were carried to all parts of the world. social matters. Virchow was a splendid of the He had in full measure the example enviable power of exciting an in¬ scholar in politics. Reference has been made already to his vestigative spirit in his Von pupils. Recklinghausen, Klebs, liberal tendencies and the fact that they brought him into

Downloaded From: http://jama.jamanetwork.com/ by a Carleton University User on 06/19/2015 governmental disfavor. He was elected as Prussian repre¬ onstrations in his honor reached their culmination on sentative in the lower house as early as in 1848, but resigned Oct. 13, 1901, his 80th birthday. Not only in Berlin but "because not old enough to hold the position legally, a position in all scientific centers was this event appropriately celebrated. to which he was elected again in 1862. Since 1861 he served Virchow himself was the recipient of some 800 congratulatory continuously in the city council of Berlin. In 1880 he was telegraphic dispatches and addresses and diplomas without end, chosen a member of the Reichstag, in which he continued to the medical profession of Austria alone sending him 80 occupy a seat for many years, taking a most active part in such. Learned societies and corporations the world over the proceedings and remaining true to his liberal convictions vied with one another in showing him all possible honor. In always. He remained a politician in the highest and best this country several banquets were arranged at which Vir¬ sense of the word throughout his long life, and his political chow's name and achievements were toasted and lauded. career alone would insure the handing down of his name to The honors heaped upon him by Germany itself through her posterity. Although not a brilliant orator in the sense the government, the learned, political, communistic and other word is used in America, his words—and he spoke frequently— societies were phenomenal. The Emperor conferred upon him were always received with attention by the Reichstag because the highest order in Prussia. Especially touching and spon¬ of the wisdom, courage and moderation of his views. Virchow taneous were the evidences of friendship and gratitude brought was Bismarck's most persistent and vigorous parliamentary by the common people from his place of birth and elsewhere. opponent and was once challenged to a duel by the man of Even the children of his neighborhood joined in the celebra¬ blood and iron, a challenge to which Virchow paid no notice. tion. But in his own words the pleasantest event to him of Science and good citizenship do not exclude each other, and the the whole celebration was a feast in a workingman's society of humanitarian side of Virchow's work is one of its most pleas¬ which he was a co-founder. His interest in the welfare of the ing features and one worthy of emulation everywhere, not least masses seems to have been nearest his heart, and in reviewing in our own country. In his various public capacities he exer¬ the eventful week of celebration of his eightieth birthday he cised an immense influence on legislation of various kinds, says: "Rely on the people and work for them and you shall not especially when it concerned matters of public health and sani¬ fail of reward, though the cessation of numerous activities, tation and the relief of the oppressed and miserable. He said: the disappearance of numerous persons, and the complete re¬ "Humanism, in its true meaning, is no apotheosis of mankind— modeling of public life, brings home the thought of our own for that would be anthropomorphism—but the scientific knowl¬ passing away." edge of the manifold and various relations of the thoughtful Virchow had great literary powers. His writings are char¬ individual man to the ever-changing world." It is this idea acterized by stringency in thought, sharpness of vision, clear¬ of humanism that led Virchow into so many politico-sociologie ness and precision of form. He was gifted with a remarkable undertakings. And so he became great in science and citizen¬ ability to work. In his later years it may have seemed to ship. many that his numerous interests removed him from imme¬ Beginning with his study of famine and fever in Upper diate touch with the results of the more modern investigations. Silesia in 1848 and a little later in the Spessart mountains, When bacteriology came upon the scene he remained sceptic we find that henceforth a large part of his time and literary and reserved, and did not take part in the new researches. He activity is given to questions of social and hygienic nature. appeared more as a man that felt his creative work to be done These investigations made clear to Virchow that he had a and that was content to rest upon his laurels. But it is to be sociologie mission to obey. For did he not learn that an essen¬ remembered that he always bowed before complete and definite tial factor in the causation of this epidemic was the miserable results, though his critical spirit never slept. "Gigantic work social condition of the people and that the only remedy was like that performed by him during the first twenty years can radical social reform ? This he lived to see realized in his own not continue for ever; one new era created can not be replaced and other countries. He became one of the foremost author¬ by another by one man." His own experience in regard to in¬ ities in Europe on matters relating to public hygiene and vestigative work is illustrated in his saying that "the silent sanitation. His efforts led to sanitary improvements in Berlin unnoticed labor of a scientist requires more energy and greater that all in all involved millions of dollars and caused a complete effort than the activity of the politician, which is both noisier change in the physiognomy of the city. He wrote on military and more speedily appreciated." And in the end the work of hygiene, on school hygiene, on the German household, on the Virchow the investigator probably will be regarded as his best best forms of exercise, etc. The legislation in regard to infectious and greatest. When everything else is forgotten the world animal diseases, fisheries, etc., bear his hallmark. He him¬ will remember the investigative work of his early manhood. self of this work as and as a mixture of spoke half-political We live in deeds, not years ; in thoughts, not breaths ; medicine and sociology, reiterating again and again the con¬ In feelings, not in figures on a dial. viction that medicine and political legislation must be brought We should count time by heart throbs. He most lives into the closest relationship if practical medicine is to exercise Who thinks most, feels the noblest, acts the best. the influence it should upon important problems in the life of the people. The present system of hospitals and institutions We have received a cablegram from Berlin announcing that of allied nature for which Berlin is noted is further per¬ a committee of American physicians attended Professor manent proof of his constructive activities. He helped to Virchow's funeral, September 9, who presented an exquisite found, and lectured to, workingmen's societies. wreath of Easter lilies and maidenhair ferns from their coun¬ and in with Few, if any, scientific medical men have received so many dem¬ trymen practicing studying Berlin, an inscription onstrations in compliment of their achievements and winning testifying to the high esteem of the medical profession of the United States for the world-renowned Rudolf personality as Rudolf Virchow. His seventieth birthday was cele¬ pathologist, brated by the publication of three large volumes of original re¬ Virchow. search by fifty-four of the most prominent medical investigators, St. Williamson of died most of them being former assistants. Virchow was a regular George Teackle, M.D., Baltimore, at his summer home near that from attendant numerous medical and other scientific societies suddenly city, August 30, upon 52. He was from the Univer¬ and congresses. For a of years he succeeded him¬ angina peetoris, aged graduated long period of in 1870, then two years at the Black- as Berliner medicinische Gessellschaft. At sity Maryland spent self president of the well's Island N. Y. He settled in Baltimore in 1872, of the International Medical he Hospital, nearly every meeting Congress and was physician of the Baltimore General Dispensary from was chosen to deliver one of the general addresses and his ap¬ 1872 to 1876, visiting physician to Bayview Asylum from pearance always caused an outburst of spontaneous applause. 1879 to 1881 and state vaccine agent of Maryland from 1882 to He refused to return his French decorations and orders, 1897. Lucretius D. M.D. pleading that science is catholic and knows no racial or Ross, Castleton (Vt.) Medical College, a member of the Vermont State Medical In and are 1857, prominent geographic bounds. Berlin, Würzburg Nürnburg Society and some-time president of the Rutland County Medical streets his name. He was member bearing honorary Society, who served during the Civil war as surgeon of the of learned societies throughout the world. These dem- Fourteenth Vermont Volunteer Infantry, died at his home in

Downloaded From: http://jama.jamanetwork.com/ by a Carleton University User on 06/19/2015 Pulteney, Vt., August 25, after an invalidism of nine years Matthias S. Wheeler, M.D. Rush Medical College, Chicago, due to paralysis, aged 75. 1868, one of the oldest physicians of Sangamon County, 111., William Faithful Hendrickson, M.D. Johns Hopkins died at his home in Auburn, August 27, from cancer of the, University, Baltimore, 1900, instructor in pathology in the stomach, after a long illness, aged 63. University of Pennsylvania, died at the Union Protestant In¬ Robert 0. Andrews, M.D. Bellevue Hospital Medical Col¬ firmary, Baltimore, from meningitis, August 21, after an ill lege, New York, 1886, a prominent practitioner of East Liver¬ ness of three months, aged 26. He was taken ill in June with pool, Ohio, and a member of the American Medical Association, broncho-pneumonia, for which he sought relief in vain in the died at his home, August 25, aged 65. Adirondack Mountains. George B. Nichols, M.D. Rush Medical College, Chicago, John Henry Longnecker, M.D. Jefferson Medical College, 1883, a prominent member of the Vermont State Medical Philadelphia, 1846, a veteran of the Civil war, in which he Society, died at his home in Barre, from Bright's disease, served as surgeon of the One Hundred and Twenty-ninth Penn¬ August 25, aged 63. sylvania Volunteers and assistant surgeon at the Annapolis Adam O. Miller, M.D. Marion-Sims College of Medicine, Hospital, and a retired practitioner of New York, died at St. Louis, 1891, after a prolonged debauch, shot and killed his is home in Islip, Long Island, N. Y., August 19, aged 80. wife and then committed suicide by taking tincture of opium Rufus W. Griswold, M.D. College of Physicians and Sur¬ August 31, aged 35. geons, New York, 1854, a prominent physician of Connecticut, George D. Perkins, M.D. of Michigan, Ann of University member of the state medical society, and twice president Arbor, 1897, a member of the laboratory staff of Parke, Davis Hartford County Medical Society, died at his home in Rocky & Co., Detroit, died at his home in that city, September 2, from Hill, August 17, from heart disease, after an illness of nearly kidney disease. two months, aged 77. Richard Oliver, M.R.C.S. and L.S..A., 1861, for Medical School of Eng., nearly Francis W. Chadboume, M.D. Maine, fifteen years resident physician at the leper settlement at Brunswick, 1869, one of the oldest practitioners of Lowell, Molokai, Hawaii, died at his residence in Waikiki, August 12, Mass., a member of the Massachusetts and Middlesex North aged 63. a of the medical societies and member of the staff Corporation Francis M.D. of Medi¬ died at his E. Rosenkrans, Cincinnati College and Lowell General hospitals, suddenly home, cine and his home in 21, 59. Surgery, 1875, died at Grand Rapids, August aged Mich., August 22, from cancer, after an illness of two months, William McD. Struble, M.D. University of Pennsylvania, 61. of the board of health of aged Philadelphia, 1885, president Trenton, A. M.D. Harvard Medical N. J., died at his residence in that city, August 28, from J. Mignault, University School, Boston, 1844, for many years coroner of the district of Terre- paralysis, aged 42. He had served as president of the Trenton Medical Association and of the Mercer County Medical Society. bonne, Quebec, died at his home in St. Benoit recently, aged 83. A. M.D. of Albert E. Evans, M.D. Medical College of Ohio, Cincinnati, George Bodamer, University Pennsylvania, of died at the State 1884, a member of the American Medical Asso¬ 1883, formerly Chicago, Dayton Hospital, Philadelphia, from 28, after a illness, 43. ciation, for a time chief resident physician of the German paresis, August long aged Hospital, Philadelphia, but of late years in private practice, Carl Patterson, M.D. Beaumont Hospital Medical College, died at his home in Philadelphia, August 20, aged 43. 1898, a young practitioner of Denison, Texas, was drowned in Red George G. Verbryck, M.D. Long Island College Hospital, while swimming River, August 24, aged 26. Brooklyn, N. Y., 1884, died at his residence in Salt Lake City, Marion Wilkerson, M.D. Medical College of Ohio, Cincin¬ from typhoid fever, August 21, after an illness of five weeks, nati, 1853, for many years a practitioner of Sabina, Ohio, died aged 43. The Salt Lake County Medical Society met, August at the Soldier's Home, Dayton, August 19, aged 83. 23, and adopted resolutions of respect and sympathy. Darwim Potter, M.D. Geneva (N. Y.) Medical College, 1860, Thomas A. Mason, M.D. Medical College of Indiana, In¬ a prominent physician of Rochester, N. Y., died suddenly at dianapolis, 1875, died from heart disease at his home in Terre Lily Dale, N. Y., from apoplexy, August 17. Haute, Ind., August 28, aged 58. The Vigo County Medical John R. Little, M.D. University of South Carolina, Colum Society, at a special meeting held August 28, passed resolu¬ bia, 1859, died at his home in Spartanburg, S. C, August 18, tions of condolence and regrets. after a protracted illness, aged 70. James L. Morrow, M.D. Medical College of Ohio, Cincin¬ William B. Swan, M.D., secretary of the Kansas State nati, 1853, a prominent practitioner of Delphi, Ind., who served Board of Health, Topeka, was drowned while boating near in the Civil war as assistant surgeon and surgeon of the Ludington, Mich., September 1. Seventy-second Indiana Volunteer Infantry, died at his home, Mortimer V. M.D. Columbia New 75. Wilkie, University, August 15, aged York, died at his home in N. Y., 31, H. Baltimore School of Cuddebackville, August Ralph Fetty, M.D. University after a short illness, 45. of the State aged Medicine, 1888, formerly assistant superintendent P. Germain M.D. Laval at W. and thereafter a of Laberge, University, Quebec, 1891, Hospital Weston, Va., practitioner died at his home in Manchester, N. from heart Camden, died suddenly at Clarksburg, W. Va., August 24, H., disease, 49. August 23, aged 38. aged Edwin a retired of James M.D. York a member Pratt, M.D., physician Bellefontaine, Pierce, New University, 1871, died his home in that from chronic of the Lawrence Medical Club and of the Massachusetts Medi¬ Ohio, at city lung disease, cal Society, died at his home in Methuen, Mass., where he had August 25, aged 75. B. J. a retired of for more than twenty-five years, 25, 54. Sapp, M.D., practitioner Kernersville, practiced August aged N. died his home in that after a M. M.D. of and C, at place long illness, Joseph McManigal, College Physicians 28, 66. Surgeons, Baltimore, 1883, for the last four years physician August aged at the Allegheny City Home, died suddenly at his residence in Roy H. Hawkes, M.D. College of Physicians and Surgeons, from heart 39. New York, 1893, died recently from pneumonia at his home in Hoboken, Pa., disease, August 29, aged New York Thomas H. Jefferson Phila¬ City. Phillips, M.D. Medical College, William D. M.D. Kansas Medical 1864, a in the the Civil and Barber, City College, delphia, surgeon Army during war, a of died at East Las N. to late President died 1887, practitioner Chicago, Vegas, M., family physician the McKinley, suddenly 23. at his home in Canton, 67. August Ohio, August 30, aged John M.D. Cincinnati John D. M.D. Detroit Medical Simison, Medieal College, 1850, died Briggs, (Mich.) College, at his home in Ind., 19, from fever, 1871, for more than 25 a of Williamson, Romney, August typhoid years practitioner aged 78. N. Y., and coroner of Wayne County for three years, died at the Rochester City Hospital, August 23, aged 66. James M. Sellers, M.D. Tulane University, New Orleans, died at his home in after a Archibald B." M.D. New York for 1875, Edna, Texas, August 24, long Lang, University, 1884, illness. 17 years a resident of Sault Ste. Marie, Mich., and in 1898 M.D. Philadel¬ mayor of that city, died at his home, August 24. He was a Thomas Hickey, Jefferson Medical College, member of the American Medical Association. phia, 1894, died at Shamokin, Pa., August 6, from tuberculosis. W. W. Gaither, M.D. Jefferson Medical College, Philadel¬ H. M. Talley, M.D. Vanderbilt University, Nashville, Tenn., phia, 1860, surgeon of the Twenty-sixth North Carolina In¬ 1857, died at Valdosta, Ga., September 1, from apoplexy. fantry, C. S. ., died at his home in Shallotte, Brunswick Ebenezer H. Thurston, M.D. University of Buffalo, 1865, County, N. C, August 18, aged about 70. died at his home in Chicago, August 25, aged 64.

Downloaded From: http://jama.jamanetwork.com/ by a Carleton University User on 06/19/2015 J. Warren Howard, M.D., died at his home in St. Paul, no albumin, no casts. Pot. ferio, cyanid, heat and nitric acid tests Ind., August 29, from heart disease, aged 63. for albumin were carefully used. Blood examination revealed many plasmodi:! malaria—crescents in all cases. After giving Thomas C. M.D., died at his home in Cleburne, Osborn, for a week or nine a speedy convalescence ensued. 20, 85. qninin days Texas, August aged The patients ranged in age from four to fifty-two years and none had had malaria for years. I would be gratified for any informa- lion as to where I can find literature on the disease or of anyone Queries and Minor Notes. with like experience. F. L. Morse, M.D.

Anonymous Communications will not be noticed. Queries for WOUNDS OP THE ABDOMEN. this column must be accompanied by the writer's name and address, Albert, W. Va., Sept. 4, 1902. but the of the writer not to his name faith¬ request publish will be To the Editor:—Kindly answer the following questions through fully observed. The Journal : 1. Given a patient with one or several stab wounds COINCIDENCE—ITS PROPER VALUE' IN DIAGNOSIS. in the abdomen, what, in your opinion, is the very shortest time in St. Louis, Aug. 25, 1902. which death could result from peritonitis? 2. What is the latest To the Editor:—I think it would serve a useful purpose if you treatment advised for gunshot wounds of the abdomen—wounds in¬ !nvited contributions to your columns concerning coincidences, flicted with the ordinary weapons? A. P. Butt. and to express more clearly what I mean I will cite two cases Ans.—1. Shock and hemorrhage can not be excluded, but when result in death in from my own practice : they are not dominant factors, peritonitis may 24 to 30 hours. 2. For the : if there is evi¬ A man came to me complaining of pain iy the testis of expert presumptive right dence of involvement of abdominal viscera, immediate two duration which to operation, days' he attributed the testes having repair of and wTashing out of the abdominal cavity. For the left damage been suddenly squeezed between thigh and a bunch of the ordinary practitioner : if there is strong evidence of visceral keys in his right trouser pocket in the act of crossing his legs. involvement, immediate operation is indicated ; if not, expectant No pain had ever been experienced in the part before. Examina¬ treatment. tion disclosed advanced tubercular epididymitis. A boy was brought to me supposed to be suffering from nervous shock, having been knocked over some days previously by a drunken man in the street. Routine examination commencing with Indexes of Medical Journals. the throat discovered Concerning diphtheria. Dillon, 4, 1902. Here is a factor, then, which, as far as I know, has never been Mont., Sept. the editorial note touched on in the treatises on diagnosis—coincidence. There is no To the Editor:\p=m-\Regarding "Concerning escape from being obliged to give it due consideration in our Indexes of Medical Journals" in The Journal of August 30: mental summing-up of the case unless we examine our patients The index furnished by The Journal is indeed a valuable ad- from a veterinary point of view—perhaps a better way—finding dition to our comfort, but even such an index can not attain out what we can by our own unaided industry. The consideration perfection, from its necessarily discontinuous publication. of the value would particular to be attached to coincidence lead I would suggest my plan of using card index. It is this: me further than it is my intention to trespass on your valuable Soon after and reading of each periodical, its space. Recitation of cases from others would not only be highly receipt contents are indexed on cards and a check mark on the instructive but also most interesting and would furnish a moral placed that it is to be filed until to adorn many a clinical tale. Yours faithfully, journal to show ready away the J. R. Clemens. volume is complete. Each periodical is given a number, which accompanies the volume numbers, for example: The Journal ETHICS IN SUCCEEDING ANOTHER PHYSICIAN. A. M. A. is No. 1. Then an article appearing in vol 39, page Lawrence, Mass, Aug. 28, 1902. 496, on "Indexes of Medical Journals" is placed on the card To the Editor:—Kindly decide this question of ethics, and oblige devoted to "Indexing" as "1, 39-496, medical journals," mean- two members of the profession in good standing and others who ing: The Journal A. M. A., vol. 39, page 496, indexing of may meet with a parallel case : A physician has been in attend¬ medical journals. ance on a and has made patient ten days (after miscarriage) I subscribe to only six journals, but in six years this visit and is to call during afternoon. Meanwhile the fam¬ morning amounts to 72 volumes and considered worth pre¬ ily desires to dispense with his services—he has been paid in full everything is at one two drawers of office for services rendered—they telephone for another physician who serving indexed place (in my desk). a I am able find has no knowldge of the circumstances until he arrives at the bed¬ Thus, in very few moments to every article side. When he is informed that a fellow practitioner is expected on a given subject in any of the 72 volumes, and without rising to call he refuses to accept the case or give an opinion and rises from my desk. The work of indexing amounts to only a few to depart. The patient and her husband state that they desire minutes each week and the short time spent on it I consider his services and shall not further employ the other physician. He most profitably employed. M. A. Walker, M.D. explains his position and ends by refusing to have anything to do with the case unless in consultation with the other physician. in Perineum Technic. The family refuse to have the other physician. "Then, you must Priority Repair Dotify your attending physician not to call any more," said the Atlanta, Ga., Aug. 19, 1902. second physician, "before I shall be at liberty to attend this pa¬ To the Editor:\p=m-\InThe Journal of the 16th inst. is a com- tient." The husband goes to the physician's office and leaves munication from Dr. Marcy of Boston in which he calls atten- notice that his services are no longer required. The husband tion to these articles of his, viz.: Transactions of the American returns and states that he was unable to see the physician per¬ Association of Obstetricians and but woi'Q at his for him not to call. Gynecologists, September sonally left office Meanwhile, 1888, "The Perineum; Its and Methods the patient suffers considerable pain. The second then accepts Anatomy, Physiology of Restoration After also "The Reconstruction of the the case, makes examination, gives opinion and outlines treatment. Injury"; He in no way solicits patronage, and neither criticised nor com¬ Pelvic Structures in Woman," American Association of Ob- mented on the previous conduct of the case. Has he (the second stetricians and Gynecologists, 1892; also "The Reconstruction physician) broken a rule of ethics or been guilty of conduct in any of the Pelvic Structures Incident to Lesions of Perineum," The way discourteous to his fellow practitioner? Very truly yours, Journal American Medical Association, October 21, 1899. He John T. Cahill. then says: "Here will be found all the essentials of Dr. Noble's stated there seems to be no violation whatever of the Ans.—As article on 'A New for Lacera- Code of Ethics. See Art. V, Sec. 4. interesting Operation Complete tion of the Perineum.'" MALARIA WITH ANASARCA. In reply to this most extraordinary claim I will state that Moshee, Ark., Aug. 27, 1902. the chief feature of my operation is elimination of the danger To the Editor:—Since locating in Arkansas I have encountered of infection from the rectum by dissecting the lower anterior a peculiar condition that the text-books fail to describe. It is an portion of the rectum free from the vagina and drawing the anasarca associated with or dependent on acute malarial infection. uninjured portion of the anterior wall of the rectum down It commences with a chill and is followed by fever and sweating. through and external to the anus, making an unbroken septum About the second or third day the swelling begins and involves the between the rectum and vagina, the com¬ whole body. The fever is now slight or wanting. The thoracic and virtually converting tear into an laceration. Dr. does not abdominal viscera are apparently normal except a slightly en¬ plete incomplete Marcy do his is larged spleen. Urine analysis: sp. gr. 1020, acid, amber, no sugar, attempt to this; operation the Tait operation modified

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